BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie

ecame enshrined in the research and treatment codes of democratic
nations.
There have been major changes in the doctor-patient relationship
over the past decades; both from patients' and doctors' point of view. There
is, indeed, some evidence that changes in society and health care have
resulted in real changes in what people expect from their doctors and in
how doctors view patients. Many patients want more information than they
are given. Many also say that they want to take an active part in decisions
about their treatment, in the light of its chances of success and any side
effects. Concepts like 'patient empowerment', 'informed consent', 'shared
decision making' and 'consumerism' have been introduced to label this
transformation of the patient role from that of passive dependency to
active autonomy. According to the literature, the traditional paternalistic
model is no longer the only, nor the preferred doctor-patient relationship
model. There is a wide consensus that a model based on a more equal
doctor-patient relationship is both beneficial for patients and more in
keeping with current ethical views.
Today, most procedures in a hospital are preceded by explanations
and discussions at the patient's bedside that make clear all the risks and
benefits of the procedure. The consent conversation must be conducted by
an MD, and the patient must be able to understand what he or she is being
asked to agree to.
Reflecting the importance of informed consent in modern health
care, an opinion from the current AMA Code of Ethics, on "Fundamental
Elements of the Patient-Physician Relationship" states: "The patient has
the right to make decisions regarding the health care that is recommended
by his or her physician. Accordingly, patients may accept or refuse any
recommended medical treatment".
As a physician, the doctor-patient relationship greatly impacts the
approach to education, motivation, and negotiation of treatment plans. In
literature are described the following four models of the physician-patient
relationship:
Paternalistic - The physician is parental, recommending what
he/she feels is best for the patient. The patient chooses whether or not to
follow the recommendations.
Informative - This is a "consumer" model of care. The
physician provides information about all available treatment choices in as
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